User Perceptions of Environmental Design in Community Clinics: Evidence from Chattogram, Bangladesh

Environment plays a crucial role in shaping user experiences, health outcomes, and accessibility of healthcare services in resource-restricted settings. For marginalised populations, community clinics serve as the foundational layer of rural health care in Bangladesh. Despite their critical role, these clinics frequently suffer from poor environmental design as well as inadequate ventilation to spatial inefficiency and cultural insensitivity. This study examines how patients and users perceive the environmental design of 15 community clinics in Chattogram, Bangladesh. As part of the qualitative, contextual experience-based methodology, data were gathered through semi-structured interviews, participant observations, and visual documentation, and then analysed thematically with NVivo. Both functionality and psychological well-being are adversely affected by environmental factors such as thermal and visual discomfort, pest intrusion, and inadequate spatial planning. However, context-responsive adaptations, such as elevated flooring and shaded outdoor spaces, highlight the potential for community-informed design strategies. A user-centred, climate-resilient, and culturally sensitive environment is essential to enhancing clinic users' safety, and health, the study concludes. As part of the recommendations, structural resilience should be enhanced, ventilation and lighting should be improved, spatial organisation should be strengthened, and locally relevant design elements should be incorporated. Insights such as these may help to rethink community healthcare environments in Chattogram and other underserved regions locally and globally.